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Questions and Answers
Which of the following is considered a contraindication for the use of therapeutic measures described?
What hazard is associated with positive airway pressure therapy?
In the context of lung expansion therapy, what does PAP stand for?
What is the main purpose of high-frequency chest wall oscillation (HFCWO) devices?
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What condition is noted as a potential complication that can lead to worsened gas exchange?
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Which of the following is NOT a contraindication listed for lung expansion therapy?
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How is the therapy session with HFCWO devices typically structured?
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What is the normal suction pressure for adults during suctioning?
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What is a common complication from inadequate humidity during airway therapy?
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Which of the following conditions requires careful consideration due to the risk of increased intracranial pressure during treatment?
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Which component is critical for the operation of high-frequency chest wall oscillation devices?
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In what settings are high-frequency chest wall oscillation devices commonly used?
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Which device is mentioned as a form of lung expansion therapy that relies on complex machinery?
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What is a potential disadvantage of percussion in patients with osteoporosis?
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What is the reported manual vibration frequency used during treatment?
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Why might patients with chronic lung disease be hesitant to try alternative methods of airway clearance?
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What can be done to prevent a fall in oxygen saturation during percussion therapy?
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Which of the following is true about mechanical percussion?
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What might be a consequence of long-term manual percussion for the caregiver?
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How is vibration typically performed during airway clearance therapy?
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What is a crucial consideration for effective percussion therapy postoperatively?
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What is one potential outcome of effective spirometry?
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Which statement accurately describes non-invasive ventilation (NIV)?
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What is a major benefit of non-invasive ventilation compared to traditional ventilation?
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Which condition is recognized as being effectively treated with non-invasive ventilation?
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How does non-invasive ventilation help with breathing effort?
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What outcome is NOT associated with successful lung expansion therapy through spirometry?
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What does increased forced residual capacity (FRC) indicate?
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Why was non-invasive ventilation developed in the early 1980s?
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What is the primary benefit of MIE in patients with NMD?
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What does PEP therapy primarily aim to prevent during expiration?
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Which of the following devices uses oscillating airway pressure for treatment?
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What mechanism allows mucus to move into larger airways during PEP therapy?
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At what pressure range do most fixed orifice devices in PEP therapy operate?
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What is a characteristic feature of oscillating/vibratory positive expiratory pressure devices?
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What range of cycles per minute do high-frequency positive airway pressure devices typically operate at?
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What type of therapy relies on chest wall recoil or active patient exhalation to function effectively?
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Study Notes
Flow Oriented Devices and Volume Oriented Devices
- Devices for airway clearance can be categorized as either flow oriented or volume oriented.
Potential Outcomes of Spirometry
- Spirometry can identify the presence of atelectasis.
- Spirometry can measure vital capacity (VC) and volume.
- Spirometry can track changes in respiratory rate and pulse rate.
- Spirometry can assess the effectiveness of lung expansion therapy.
Devices/Techniques for Lung Expansion Therapy
- Non-invasive ventilation (NIV) was first developed in the early 1980s.
- NIV provides breathing support for patients with inadequate ventilation.
- NIV is effective for patients with chronic obstructive pulmonary disease (COPD).
- NIV can help reduce the risk of infections and sedation compared to invasive ventilation due to the absence of an artificial airway.
Contraindications for Non-invasive Ventilation (NIV)
- There are no absolute contraindications for NIV.
- NIV should be avoided in patients with increased intracranial pressure (ICP) above 15 mmHg.
- NIV is not recommended for patients with active hemoptysis, hemodynamic instability, recent facial, oral, or skull surgery, tracheoesophageal fistula, active untreated tuberculosis, radiographic evidence of bleb, or singultus (hiccups).
Hazards and Complications of Non-invasive Ventilation (NIV)
- Possible hazards and complications include increased airway resistance, barotrauma, pneumothorax, nosocomial infection, psychological dependence, impedance of venous return, exacerbation of hypoxemia, hyperventilation or hypocapnia, hypoventilation, hemoptysis, increased V/Q mismatch, hyperoxia, gastric distention, and air trapping.
Devices/Techniques for Lung Expansion Therapy
- Positive airway pressure (PAP) therapy uses positive pressure to increase the pressure gradient and improve lung expansion.
- PAP therapy does not require complex machinery.
Percussion
- Percussion can be used to enhance secretion clearance and shorten treatment duration.
- Percussion may not be well-tolerated by patients postoperatively without adequate pain control.
- Percussion can pose a risk to patients with osteoporosis or coagulopathy.
- Percussion can lead to a decrease in oxygen saturation.
- Percussion could lead to repetitive motion injuries for caregivers who provide long-term treatments.
Vibration
- Vibration is another method to loosen or move bronchial secretions.
- Vibration can be manual or mechanical.
- It is performed in postural drainage positions to clear secretions.
- Vibration can be used to assist patients with neuromuscular diseases (NMD) to generate sufficient expiratory flow rates for secretion clearance.
PEP Therapy
- Positive expiratory pressure (PEP) therapy involves active expiration against a fixed or variable orifice flow resistor.
- PEP therapy is designed to prevent airway collapse during expiration and facilitate mucus clearance.
High-Frequency Positive Airway Pressure Devices
- High-frequency positive airway pressure devices use rapid pressurized gas mini-bursts to clear airways.
- These devices allow patients to inhale and exhale while the oscillating airway pressure is applied.
High-Frequency Chest Wall Oscillation (HFCWO) Devices
- HFCWO devices use a vest system to create pressure pulses against the thorax, leading to chest wall oscillations.
- HFCWO devices are typically used for 30-minute sessions 2-6 times per day.
Suctioning
- Suctioning is an invasive technique for the removal of airway secretions.
- Suctioning involves applying negative pressure to the airway through a collecting tube.
- The normal suction pressure for adults is less than 200 mmHg.
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Description
This quiz explores various techniques and devices used for respiratory care, focusing on flow-oriented and volume-oriented devices. It covers the potential outcomes of spirometry, the role of non-invasive ventilation in lung expansion therapy, and contraindications for its use. Test your knowledge on these essential respiratory practices.
